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Children lose muscle during early cancer treatment — new ECU study warns of a hidden danger to recovery

New research from Edith Cowan University has highlighted that children undergoing cancer treatment often lose skeletal muscle at a time when they should be rapidly gaining it.

Woman in doctor's coat holding the hands of a child. Losing muscle also makes children and adolescents more vulnerable to heart and metabolic problems.

New research from the Exercise Medicine Research Institute at Edith Cowan University (ECU) has highlighted that children undergoing cancer treatment often lose skeletal muscle at a time when they should be rapidly gaining it, a loss that could increase treatment complications and raise the risk of long-term health problems.

"Both the cancer itself and the cancer treatment can cause muscle loss in children," said ECU PhD student Anna Maria Markarian.

"Muscle is the body's metabolic reserve. When children lose muscle during treatment, they tolerate chemotherapy less well and face a higher risk of complications from drug toxicity."

Losing muscle also makes children and adolescents more vulnerable to heart and metabolic problems such as high blood sugar and insulin resistance, Ms Markarian said.

"For example, during the onset of puberty children gain 3 kg to 5 kg of muscle per year. If treatment interrupts this growth and it isn't recovered afterwards, it can severely impact health outcomes in the longer term."

The research, Longitudinal changes in skeletal muscle in children undergoing cancer treatment: a systematic review and meta-analysis, found that children undergoing cancer treatment are likely to experience increases in fat mass, which can further contribute to metabolic problems and increase the risk of heart-related issues.

"Weight is not the whole story. Two kids can weigh the same, one with healthy muscle, one with excess fat, and their ability to tolerate chemotherapy could be very different.

"The challenge here is differentiating between muscle loss and fat gain, as this could have important clinical implications. Shifts in body composition can create a mismatch between dosing assumptions and actual metabolic capacity, heightening the risk of treatment-related complications and poorer clinical outcomes in patients with diminished skeletal muscle mass," Ms Markarian said.

The message for parents is simple: keep kids moving. Encourage age-appropriate active play and exercise, despite the obvious difficulties that would be associated with that.


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